Creating Fulfillment and Financial Independence in Medicine

In a previous post, Dr. Dahle delivered 5 excellent tips to achieve financial freedom and touched on the relationship between financial independence and fulfillment as a physician. I would like to continue the conversation by discussing how I achieved financial independence at age 39, and how it allows me the freedom to practice medicine in a way that keeps me happy.

Financial independence is defined as having enough money saved and invested in a way that would allow you to quit gainful employment and continue your present standard of living. The math, based on a 4% withdrawal rate, requires you to have at least 25 years worth of expenses saved to have your financial freedom. If your household spends $100,000 a year, you need a minimum of $2.5 million. If you are one person spending $40,000, a million dollar nest egg does the trick

I discovered the concept, the math, and the online FIRE (financial independence retire early) community late in 2014. I was in the middle of studying for a Board maintenance of certification exam, my PALS certification was up for renewal, and I wasn’t feeling too keen on certain aspects of my career. After shoring up the certifications, I focused on my finances.

Fortunately, I had been reasonably smart with my money over the years. I chose a full ride to my state school over an Ivy league college education, and stayed on at State U for medical school. I was able to earn my M.D. with a healthy 5-figure debt in 2002.

I chose a specialty that I found rewarding both mentally and financially. Anesthesia requires instant decision-making and delivers fast results. I use both my hands and my mind and although the hours and stressors can be rough, the compensation reflects that reality.

My career didn’t unfold the way I had planned. A hospital bankruptcy about 5 years into my career sent me back onto the locum tenens circuit I had chosen when I finished residency. Locums was a great way to start a career, but it was far from my ideal practice now that I had a wife, 2 very young boys, and one oversized doctor’s home. Four years and two jobs later, I have a great job, the oversized home has been sold, and according to the math outlined previously, I can call myself financially independent.

I didn’t follow a particular plan or get lucky with investments. I simply worked hard (like a resident), lived well below my means, and invested my earnings sensibly and continually, not panicking when the bottom fell out of the markets early in my career.

I work by choice. I still like receiving a paycheck and watching our nest egg grow, but I know that if I stopped going to work, my family and I would have enough money to maintain a comfortable standard of living. The fact that I have no plans to retire in the near future is a testament to the fact that I still enjoy my job.

I am better able to focus on the positive aspects of the job. Before I had financial freedom, I focused more on the negative aspects, the hurdles and hoops that stand as obstacles between the patient and me. Now that I’m working by choice, I realize that I continue to enjoy medicine in spite of the bureaucracies. There is honor in caring for patients. Every workday, I take away pain and maintain life while powerful drugs make my patients insensate to insult from knives, saws, drills, and screws. Working that kind of magic as if it’s routine is actually pretty amazing when you take two steps back and think about it.

I’m in a better position to create the job I want. If overnight call becomes too much of a burden, I have leverage to make it disappear. An outpatient surgery center position, with a more predictable schedule and fewer sick patients might have lower pay, but I can accept a pay cut for a lower stress job that lets me sleep in my own bed every night. When you rely on each and every paycheck to maintain a lifestyle, you’ve got no leverage to create that change.

I also have the power to walk away. I do intend to retire early at some point, but I don’t feel at all ready to leave clinical medicine behind at age 40. In the meantime, I can do my best to enjoy my work, while padding the nest egg and devoting more and more of my income to charitable causes. It is comforting to know though, in the meantime, that if something drastic were to happen in my work or personal life, I have the ability to let go of the white coat and pager.

I find the fact that I could be done with medicine tomorrow, combined with the fact that I don’t want to be, very fulfilling.